Tinea Imbricata Research Articles

Infection patterns of scabies and tinea between inland and resettled indigenous Negrito communities in Peninsular Malaysia.

Skin infections cause significant health burden and affect underserved communities such as the indigenous Negrito communities disproportionately. There is only one study that has addressed skin infections among the Negrito communities, which is the smallest and most isolated indigenous tribe in Peninsular Malaysia, with approximately 6,500 individuals remaining in northern and central Peninsular Malaysia. This study, which aims to update the infection patterns of scabies and tinea among the Negrito communities, recruited 361 participants from eight villages representing all six Negrito subtribes. The results revealed an overall skin infection prevalence of 35.6%, with scabies (11.7%), tinea versicolor (11.3%), and tinea imbricata (7.5%) as major infections, with no co-infection. Notably, infection rates were significantly higher in resettled villages (55.2%) compared to inland villages (24.8%). Scabies and tinea versicolor were more prevalent in resettled villages (21.2% and 23.6%, respectively) than inland villages (6.4% and 4.7%, respectively), while tinea imbricata was more common in inland villages (9.4% vs 3.9%). Furthermore, there exist predisposition of scabies among Kensiu. High prevalence of tinea imbricata was observed among the inland Bateq while prevalence of tinea versicolor was high among the resettled Bateq. Risk analysis revealed specific associations: scabies with Kensiu subtribe (P = 0.002), high income (P = 0.001) and underweight individuals (P = 0.009); tinea versicolor with Bateq subtribe (P = 0.003), resettled villagers (P < 0.001), males (P = 0.040), and overweight/obese individuals (P = 0.015); and tinea imbricata with Bateq (P = 0.011) and smokers (P = 0.004). These findings highlight a complex interplay between environment and lifestyle in skin infection prevalence. Addressing these infections requires targeted interventions, including regular medical care in inland villages and socio-economic support for resettled communities, considering the distinct predispositions in different village types.

Health service needs and perspectives of a rainforest conserving community in Papua New Guinea’s Ramu lowlands: a combined clinical and rapid anthropological assessment with parallel treatment of urgent cases

ObjectivesDetermine community needs and perspectives as part of planning health service incorporation into Wanang Conservation Area, in support of locally driven sustainable development.DesignClinical and rapid anthropological assessment (individual primary care...

Association of Kallikrein Related Peptidase 3 (KLK3) gene with dermatophytosis in the UK biobank cohort.

In a previous genome wide association study (GWAS) of UK Biobank (UKB) data, we identified one susceptibility locus, tubulointerstitial nephritis antigen (TINAG), with genome wide significance for dermatophytosis. We used genotype calls from file UKB22418. These data are derived directly from Affymetrix DNA microarrays but are missing many genotype calls. Using computationally efficient approaches, UKB has entered imputed genotypes into a second dataset, UKB22828, increasing the number of testable variants by over 100-fold to 96 million variants. In the current study, we used UKB imputed genotypes in UKB22828 to identify dermatophytosis susceptibility loci. To identify cases of dermatophytosis, we used ICD10 code B35, which covers tinea barbae, tinea capitis, tinea unguium, tinea manuum, tinea pedis, tinea corporis, tinea imbricata, tinea cruris, other dermatophytoses and dermatophytosis, unspecified. We used PLINK, a whole-genome association analysis toolset, to analyse the UKB22828 chromosome files. GWAS summary (Manhattan) plot of the meta-analysis association statistics highlighted two susceptibility loci, TINAG and Kallikrein Related Peptidase 3 (KLK3), with genome wide significance for dermatophytosis. KLK3, also known as prostate specific antigen (PSA), belongs to a subclass of serine proteases with a variety of physiological functions. KLK3 may be a dermatophytosis susceptibility gene. KLK3 could affect risk of dermatophytosis, since kallikreins are necessary for normal homeostasis of the skin.

Tinea Imbricata: Case Series on Three Patients in Sarangani, Philippines

Tinea imbricata or Tokelau ringworm is an unusual superficial dermatophytosis caused by the anthropophilic Trichophyton concentricum. Three cases of Tinea imbricata observed at the Municipal Health Office of Kiamba, Sarangani Province, Philippines are reported in this study. All three patients were from an indigenous ethnic group of Sarangani Province and lived in isolated upland communities. Patient 1 was a 30 year old male, Patient 2 was a 40 year old female, and Patient 3 was a 19 year old female. Lesions lasted ~27 years, ~25 years, and 2 years, respectively. All patients presented with characteristic extensive polycyclic to serpiginous scaling lesions, with areas of sparing. Microscopic examination of skin scrapings prepared with potassium hydroxide revealed the characteristic broad, branched, septate, irregular hyphae. Trichopyton concentricum, the causative agent, was isolated in one of the patients using Mycobiotic agar. Histopathologic examination on 2 of the patients revealed acute and chronic inflammation, and Periodic Acid Schiff-positive fungal hyphae. All patients were started on Griseofulvin 500mg tab once daily. The case series presented here is the first account of Tinea imbricata in the Philippines since the 1990s.&#x0D; &#x0D;

A Case of Tinea pseudoimbricata Caused by Microsporum Audouinii

Tinea pseudoimbricata has morphological similarity to Tinea imbricata which is characterized by multiple concentric rings, but it is caused by dermatophytes other than Trichophyton Concentricum. We report a case of tinea pseudoimbricata caused by Microsporum Audounii that presented with multiple concentric scaly annular erythema. The most common clinical presentation of pseudoimbricata was tinea corporis followed by Tinea cruris. However, tinea imbricate-like lesions are very rare. Tinea pseudoimbricata is considered a unique sub-type of Tinea incognito which caused by inappropriate use of topical steroid. Both Fungal culture and microscopic findings confirmed Microsporum Audouinii infection in this case. The patient was treated with oral terbinafine according to culture and antifungal sensitivity testing at a dose of 250 mg/day for 8 weeks.

Genome-wide association study of dermatophytosis in the UK Biobank cohort.

Analyses of the hereditary propensity to dermatophytosis have revealed several proven genetic relationships. They include CARD9 deficiency, HLA-DR4 and HLA-DR8 type and genes encoding interleukin-22, defensin 2 and 4, and genetic defects in dectin-1, which increased the prevalence of dermatophytosis in families and were involved in the inheritance of susceptibility in their members. To further investigate the genetic basis of dermatophytosis, we performed a genome-wide association study (GWAS) of the UK Biobank cohort. To identify cases of dermatophytosis, we used ICD10 code B35, which covers Tinea barbae, Tinea capitis, Tinea unguium, Tinea manuum, Tinea pedis, Tinea corporis, Tinea imbricata, Tinea cruris, other dermatophytoses and dermatophytosis, unspecified. Data processing was performed on Minerva, a Linux mainframe with Centos 7.6, at the Icahn School of Medicine at Mount Sinai. We used PLINK, a whole-genome association analysis toolset, to analyse the UKB chromosome files and the UK Biobank Data Parser (ukbb parser), a python-based package that allows easy interfacing with the large UK Biobank dataset. We used LocusZoom for the Manhattan and q-q plots. Other statistical analyses were done with R and SPSS 25. Genome-wide association study (GWAS) and meta-analysis association statistics highlighted one susceptibility locus, Tubulointerstitial Nephritis Antigen (TINAG), with genome-wide significance for dermatophytosis. The top SNP was rs16885197, a missense variant within TINAG, position chr6:54308557, alleles A > G, minor allele frequency (MAF) 0.014. Multivariate logistic regression indicated that the minor G allele increased odds ratio of dermatophytosis by 7.8. Carrying two G alleles raised dermatophytosis odds ratio by a factor of 14. More research into genetic and other predisposing factors for dermatophytosis is critical because of the implications for prophylaxis and therapy. It might be possible to prevent infection and recurrence by identifying people who are vulnerable to chronic dermatophytosis. Identifying high-risk families would enable their members to be educated about the dangers of fungal diseases. New therapeutic techniques to target altered hormonal and immune response pathways might be created. TINAG is a prospective target that should be investigated, based on the findings of this article.

Tinea Imbricata among the Indigenous Communities: Current Global Epidemiology and Research Gaps Associated with Host Genetics and Skin Microbiota.

Tinea imbricata is a unique fungal skin disease that mostly affects indigenous populations in Southeast Asia, Oceania, and Central and South America. The control and management of this disease among these communities are challenging given their remote locations, certain traditional practices, and severe malnutrition status. To date, there are only a handful of reports published globally, which highlights the need for a more holistic approach in addressing this skin disease. Several bodies of evidence and reports have shown that host genetic factors have a profound influence on the pathogenesis of tinea imbricata, while skin microbiota is touted to have a role in the pathogenesis of the disease. However, there are limited studies of how host genetics and skin microbiota impact disease susceptibility in the host. To improve the understanding of this disease and to find possible long-term effective treatment among the affected indigenous communities, a comprehensive literature review is needed. Hence, this review paper aims to present the current status of tinea imbricata among the indigenous communities, together with published findings on the possible underlying reasons for its specific distribution among these communities, particularly on the ways in which host skin microbiota and host genetics affect occurrence and disease patterns. This information provides valuable insights for future research by highlighting the current knowledge gaps in these areas.

A Clinico Mycological Study of Tinea Pseudoimbricata.

Introduction:Tinea pseudoimbricata is a variant of dermatophytosis characterized morphologically by concentric scaly rings resembling tinea imbricata with an culture isolate other than Trichophyton concentricum. To date, no large case report series is available.Aim:To study the clinical profile and the fungus isolated in patients with tinea pseudoimbricata.Materials and Methods:In this case series, all the patients with tinea imbricata with an isolate other than Trichophyton concentricum were subjected to a detailed history and clinical examination. Scrapings of the scales were investigated with potassium hydroxide examination and culture in Sabouraud Dextrose Agar enriched with cycloheximide and chloramphenicol. The results obtained were tabulated and analyzed.Results:A total of 42 patients fulfilling the above culture criteria were included in the present study. A majority were in the age group of 21–40 years (54.70%) with a male preponderance (M:F = 2:1). All the patients had abused steroids for more than 4 weeks and had multiple site involvement. Trichophyton tonsurans (42.8%) was the predominant isolate cultured, followed by Trichophyton mentagrophytes.Conclusion:Hence, as per our study, tinea pseudoimbricata is encountered more often nowadays due to the misuse of topical steroids and to diagnose tinea pseudoimbricata culture is mandatory. The morphology of concentric rings is not restricted to Trichophyton concentricum, but can occur with other species depending on the clinical scenario.

Annular infectious dermatoses

Annular configuration is conspicuous in the clinical manifestation of many skin diseases and can be helpful for the diagnosis and differential diagnosis. Variations may include arciform, ring-form, annular, circinate, serpiginous, gyrated, polycyclic, targeted or figurate forms, in different colors, sizes, and numbers, with various textures and surfaces. In infectious dermatoses, the annular reactions can be specific or nonspecific, while the underlying mechanisms remain largely unknown. In the specific reactions caused by direct invasion of the pathogens, the contest between the centrifugal outspread of the infectious agents and the centripetal impedance of the host immune response is supposed to determine the final conformation. Examples include erythema infectiosum, orf, erythema multiforme, and pityriasis rosea of viral origin. Bacterial infections that may display annular lesions include erythrasma, erythema (chronicum) migrans of Lyme borreliosis, secondary syphilis, cutaneous tuberculosis, and leprosy. Superficial mycosis, such as dermatophytosis, candida intertrigo, tinea imbricata, and subcutaneous mycosis, such as chromoblastomycosis, and algae infection protothecosis, are characterized by annular progression of the skin lesions. The creeping serpiginous extension is an alarming sign for the diagnosis of cutaneous larva migrans. A better understanding of the virulence and pathogenicity of the pathogens and the way and type of immune response will help to clarify the pathogenesis.

Clinical Appearance Of Tinea Corporis Resembles With Tinea Imbricata And Condyloma Acuminata Genital In A Reproductive Woman With HIV : A Case Report

Background: HIV (human immunodeficiency virus) is a virus that attacks the body’s immune system that can cause immunodeficiency. Immunodeficiency results in increased susceptibility to fungal infections. The other opportunistic infection, condyloma acuminate is prevalent in groups at high risk for HIV acquisition and in HIV-infected individuals. Case: There were ring-shaped reddish patches with scaly and itchy on the right back since 3 weeks ago. Patients often scratch it especially when sweating and hot weather. The itchy reddish patches with scaly were increased in number and size on the right back then spreading over the edge to form ring-like patches. Patient complained ring-shaped reddish patches getting more red, scaly, itchy, and wider. 6 months ago, there was a lump that sometime felt itchy in below part of vulva. Patient in reproductive age and not married yet, but sexually active. Patient had a sexual relation with male who HIV 2 years ago. Patient also suffered HIV and got ARV since 6 month ago. There was no protection (condom) during the sexual intercourse. Dermatologic state in right back with efflorescence is plaque erythema with annular concentric ring forms, scale, and blackish crust. Venereologycal state show vegetation in vulva with size 0,2 - 1,5 x 1 x 0,5 cm with verrucous surface. Acetowhite test is positive result. KOH 10% of skin scrapping show fungal element and fungal culture result is tricophyton rubrum. Patient was diagnosed tinea corporis (TC) and condyloma acuminata (CA) genital griseovulfin 900 mg, cetirizin 10 mg, ketokonazol 2% cream twice a day, tricholoroacetat 90% and showed good improvement.Discussion: Diagnosis tinea corporis and CA genital based on clinical findings and mycological examination. Early diagnosis and proper treatment are important in HIV patients in order to prevent severe infection. After 4 weeks treatment, show improvement on TC however CA lesion no reduced. Keywords: tinea corporis,condyloma acuminate, tinea imbricata, HIV, Reproductive age

A Case of Tinea Pseudoimbricata by Trichophyton tonsurans

Tinea imbricata is a unique dermatophytosis caused by Trichophyton concentricum, observed endemically in subtropical to torrid zones. It is characterized by development of impressive concentric rings on the trunk or limbs. And few dermatophytosis cases mimicking this disease are reported as "tinea pseudoimbricata". Herein, we report a case of tinea pseudoimbricata caused by T. tonsurans with multiple concentric annular erythemas. The common clinical manifestations of T. tonsurans infection are tinea capitis and tinea corporis. However, tinea imbricate-like lesions are very rare. Fungal culture and microscopic findings confirmed a T. tonsurans infection in this case. The patient was treated with topical isoconazle and additional oral terbinafine.

Senna (Cassia) alata (Linn.) Roxb. leaf decoction as a treatment for tinea imbricata in an indigenous tribe in Southern Philippines.

Tinea imbricata, a rare form of tinea corporis caused by Trichophyton concentricum, is endemic to the T'boli tribe in the Southern Philippines. Temporary remissions and limited access to antifungal medications make its treatment a pressing public health concern. Anecdotal reports about the use of Senna alata leaf decoction as treatment exist. To determine the efficacy of community-prepared S alata leaf decoction in the treatment of tinea imbricata. Tinea imbricata patients were instructed to apply S alata leaf decoction for 4weeks (28±3days). Disease severity, pruritus visual analogue scale scores (VAS) and potassium hydroxide (KOH) mounts of skin scrapings were evaluated before and after treatment. Two assessors evaluated disease severity based on photographs. Cohen's kappa statistics were used to assess diagnostic concordance. Adverse drug events were recorded. Twenty patients were enrolled. After 4weeks, 95% had decreased pruritus VAS scores, with a mean decreased of 4.05 after treatment (P<.0001). There was a significant difference in disease severity scores before and after treatment (P≤.05) with an overall agreement of 'moderate' for both assessors (κ=0.6, 95% CI [0.33, 0.87]). Forty per cent had negative KOH tests after treatment. None had adverse drug events. This is the first study that showed the potential of a community-prepared leaf decoction as a treatment option for tinea imbricata. Larger clinical trials establishing its efficacy, effectiveness and safety profile are recommended to enable its promotion among the indigenous people and health authorities as an accessible and affordable treatment for tinea imbricata.

Tinea Imbricata: An Overview.

Tinea imbricata is a chronic superficial mycosis caused mainly by Trichophyton concentricum. The condition mainly affects individuals living in primitive and isolated environment in developing countries and is rarely seen in developed countries. Physicians in nonendemic areas might not be aware of this fungal infection. To familiarize physicians with the clinical manifestations, diagnosis, and treatment of tinea imbricata. A PubMed search was completed in Clinical Queries using the key terms "Tinea imbricata" and "Trichophyton concentricum". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, reviews, and case reports. The information retrieved from the above search was used in the compilation of the present article. The typical initial lesions of tinea imbricata consist of multiple, brownish red, scaly, pruritic papules. The papules then spread centrifugally to form annular and/or concentric rings that can extend to form serpinginous or polycyclic plaques with or without erythema. With time, multiple overlapping lesions develop, and the plaques become lamellar with abundant thick scales adhering to the interior of the lesion, giving rise to the appearance of overlapping roof tiles, lace, or fish scales. Lamellar detachment of the scales is common. The diagnosis is mainly clinical, based on the characteristic skin lesions. If necessary, the diagnosis can be confirmed by potassium hydroxide wet-mount examination of skin scrapings of the active border of the lesion which typically shows short septate hyphae, numerous chlamydoconidia, and no arthroconidia. Currently, oral terbinafine is the drug of choice for the treatment of tinea imbricata. Combined therapy of an oral antifungal agent with a topical antifungal and keratolytic agent may increase the cure rate. In most cases, a spot diagnosis of tinea imbricata can be made based on the characteristic skin lesions consisting of scaly, concentric annular rings and overlapping plaques that are pruritic. Due to popularity of international travel, physicians involved in patient care should be aware of this fungal infection previously restricted to limited geographical areas.

A SYSTEMATIC REVIEW OF DIAGNOSIS AND TREATMENT OPTIONS FOR TINEA IMBRICATA

Tinea imbricata is a cutaneous fungal disease and sometimes called (Tokelau). The causative agent is a dermatophyte known as Trichophyton concentricum. It is an endemic in developing countries particularly in South Pacific, India, Central and South America, as well as Mexico. It is generally observed in people with poor living conditions and poor personal hygiene. Predisposing factors are hot weather, humidity, and host immunity in addition to genetic factors. The patients usually presented with concentric or lamellar skin lesions. The aim of this review is to highlight important information about microbial, clinical and therapeutic aspects of tinea imbricta. In this review, we search the literature to identify articles talking different aspects of tinea imbricta. The electronic search was performed in four databases to identify eligible articles in the literature. Electronic databases were searched including MEDLINE and EMBASE using PubMed search engine. In addition, Cochrane library and ovid was searched. The titles and abstracts of the resulted articles were screened to identify eligible studies. Based on the primary screening results the irrelevant studies, duplicated and reviews were excluded. Tinea imbricta is found to be endemic in 3 main geographical regions, Southwest Pacific, Southeast Asia, and Central and South America. There is an autosomal recessive genetic factor which increases the vulnerability to tinea imbricta infection. The levels of both general and specific IgE class antibodies were higher than normal values. Usual clinical findings of tinea imbricta are multiple annular, concentric, squamous sores and may be associated with erythema. The infection usually starts in young people on the facial region and disseminate to the trunk, arms or legs.The eradication of the disease has not been possible yet, thus preventative procedures should be adopted as a strategy of disease control.

Tinea Pseudoimbricata as a Unique Manifestation of Steroid Abuse: A Clinico-Mycological and Dermoscopic Study from a Tertiary Care Hospital.

Background:Tinea pseudoimbricata, characterized by concentric scaly rings simulating Tinea imbricata is caused by dermatophytes other than Trichophyton concentricum. It is reported to occur in patients with steroid abuse and in immunocompromised individuals.Aim:To study the clinico-mycological profile and dermoscopic features of T. pseudoimbricata in immunocompetent patients.Methods:We have evaluated 14 consecutive, clinically diagnosed patients of T. pseudoimbricata with positive 10% potassium hydroxide (KOH) examination and culture, seen over a period of 6 months. Dermoscopy was performed in all patients. The demographic, clinical, and mycological features of each patient were recorded on a predesigned proforma.Results:There were seven male and seven female patients with a mean age of 27.6 years and a mean disease duration of 3.8 months. All patients gave a history of application of potent or super-potent topical steroid with or without oral/injectable steroid for varying duration. Culture isolates were Trichophyton mentagrophytes complex and Trichophyton rubrum in 11 and 3 patients, respectively. Dermoscopic analysis showed features of steroid abuse in majority of the patients.Limitation:A small sample size was the limitation of our study.Conclusion:T. pseudoimbricata is a special subset of Tinea incognito caused by injudicious and inappropriate use of topical steroid. The typical appearance should alert the dermatologists regarding the possible abuse of steroids. Most common species isolated on culture was T. mentagrophytes complex.

The efficacy of akapulko (Senna alata) decoction as a treatment for tinea imbricata among the T’boli tribe in Kiamba, Sarangani: A pilot study

The efficacy of akapulko (Senna alata) decoction as a treatment for tinea imbricata among the T’boli tribe in Kiamba, Sarangani: A pilot study

Bakua: tinea imbricata in the solomon islands.

Tinea imbricata or tokelau is a chronic superficial mycosis caused by Trichophyton concentricum.1 The disease is endemic in the Pacific, including on the Solomon Islands, where it is known as bakua. The disease predominantly affects individuals living in poor rural communities with limited access to hygiene. It is estimated that between 10% and 20% of individuals in some Pacific countries are affected. Tinea imbricata begins in childhood and affects both sexes. Skin lesions can affect the whole body, but the limbs and torso are most commonly involved. Lesions begin as concentric, annular plaques with or without erythema (Figure 1 Figure 1. Classical lesion of tinea imbricata on the arm of a child from the Solomon Islands. ). Over time, multiple overlapping lesions develop (Figure 2 Figure 2. Multiple overlapping lesions of tinea imbricata on the legs of the same child from the western province of the Solomon Islands. ). Pruritus is frequent. The florid nature of tinea imbricata can make infection socially stigmatizing. The disease has a classical appearance, and diagnosis is clinical, although fungal scrapings and culture are possible. There is thought to be a genetic pre-disposition, with both autosomal-recessive and -dominant inheritance described. Individuals who develop tinea imbricata have impaired immune responses to fungal antigens, but the precise mechanism is not well understood.1 Current treatment options are limited, with griseofulvin or oral terbinafine preferred.2 Even with prolonged treatment, recurrence rates are high, and a more efficacious treatment regimen is needed.

A Case of Tinea Imbricata in an Italian Woman

A Case of Tinea Imbricata in an Italian Woman

Tinea capitis in the form of concentric rings in an HIV positive adult on antiretroviral treatment

Dermatophyte infection may present in the form of concentric rings caused by Trichophyton concentricum, known as Tinea Imbricata. In immunosuppressed patients, there are reports of lesions in the form of concentric rings caused by dermatophytes other than Trichophyton concentricum too, mostly by Trichophyton tonsurans, known as Tinea indesiciva or Tinea pseudoimbricata. We report a case of tinea capitis in a HIV-positive adult woman on antiretroviral therapy, who presented with concentric rings of papules and pustules with slight scaling on the scalp along with diffuse thinning of hair. Both Potassium hydroxide mount and culture showed the presence of Dermatophytes. Tinea capitis is considered rare in adults, but new cases are being reported in immunocompromised as well as in immunocompetent patients. The pertinent features of this case are: HIV-positive adult female on antiretroviral therapy, presenting with tinea capitis in the form of concentric rings; culture from the lesion grew Microsporum audouinii; responding to oral Terbinafine.

Tinea imbricata in the Americas

The aim is to provide an overview on tinea imbricata, or Tokelau, a superficial mycosis caused by Trichophyton concentricum, a strictly anthropophilic dermatophyte with a well-defined geographic distribution and predisposing factors that include genetic, racial and immunologic susceptibility patterns and a specific environment. This review covers the most interesting aspects of the infrequent disease tinea imbricata, including the historical background, the epidemiologic aspects, highlighting the genetic and racial patterns of susceptibility to the acquisition of the disease, and the immunologic aspects that help to explain its clinical behavior. We also present a clinical description of the disease, the differential diagnosis and how currently some other emerging diseases such as syphilis in immunocompromised patients can mimic tinea imbricata. The therapeutic options are still griseofulvin and nowadays terbinafine, but the access to the treatments in the endemic zones and the changes in habits of the affected population make control and prevention of the disease difficult. Tinea imbricata, or Tokelau, remains an infrequent superficial mycosis restricted to endemic zones in the South Pacific islands (Polynesia and Melanesia), South Asia and some specific areas of South America. Migration phenomena and global changes in the climate may modify the incidence and characteristics of the disease.